

THE PANCREAS 1201 



the groove between the duodenum and the right lateral and lower borders in front 

 are the anastomosing superior and inferior pancreaticoduodenal arteries; the com- 

 mon bile duct descends behind, close to the right border, to its termination in the 

 descending part of the duodenum. 



Anterior Surface. The greater part of the right half of this surface is in contact 

 with the transverse colon, only areolar tissue intervening. From its upper part 

 the neck springs, its right limit being marked by a groove for the gastroduodenal 

 artery. The lower part of the right half, below the transverse colon, is covered 

 by peritoneum continuous with the inferior layer of the transverse mesocolon, 

 and is in contact with the coils of the small intestine. The superior mesenteric 

 artery passes down in front of the left half across the uncinate process; the superior 

 mesenteric vein runs upward on the right side of the artery and, behind the neck, 

 joins with the lienal vein to form the portal vein. 



Posterior Surface. The posterior surface is in relation with the inferior vena 

 cava, the common bile duct, the renal veins, the right crus of the diaphragm, and 

 the aorta. 



The Neck springs from the right upper portion of the front of the head. It is 

 about 2.5 cm. long, and is directed at first upward and forward, and then upward 

 and to the left to join the body; it is somewhat flattened from above downward 

 and backward. Its antero-superior surface supports the pylorus; its postero- 

 inferior surface is in relation with the commencement of the portal vein; on the 

 right it is grooved by the gastroduodenal artery. 



The Body (corpus pancreatic) is somewhat prismatic in shape, and has three 

 surfaces: anterior, posterior, and inferior. 



The anterior surface (fades anterior) is somewhat concave; and is directed for- 

 ward and upward: it is covered by the postero-inferior surface of the stomach 

 which rests upon it, the two organs being separated by the omental bursa. Where 

 it joins the neck there is a well-marked prominence, the tuber omentale, which 

 abuts against the posterior surface of the lesser omentum. 



The posterior surface (fades posterior) is devoid of peritoneum, and is in contact 

 with the aorta, the lienal vein, the left kidney and its vessels, the left suprarenal 

 gland, the origin of the superior mesenteric artery, and the crura of the diaphragm. 



The inferior surface (fades inferior] is narrow on the right but broader on the left, 

 and is covered by peritoneum; it lies upon the duodenojejunal flexure and on some 

 coils of the jejunum; its left extremity rests on the left colic flexure. 



The superior border (margo superior) is blunt and flat to the right; narrow and 

 sharp to the left, near the tail. It commences on the right in the omental tuber- 

 osity, and is in relation with the celiac artery, from which the hepatic artery 

 courses to the right just above the gland, while the lienal artery runs toward the 

 left in a groove along this border. 



The anterior border (margo anterior) separates the anterior from the inferior 

 surface, and along this border the two layers of the transverse mesocolon diverge 

 from one another; one passing upward over the anterior surface, the other 

 backward over the inferior surface. 



The inferior border (margo inferior) separates the posterior from the inferior 

 surface ; the superior mesenteric vessels emerge under its right extremity. 



The Tail (cauda pancreatis) is narrow; it extends to the left as far as the lower 

 part of the gastric surface of the spleen, lying in the phrenicolienal ligament, 

 and it is in contact with the left colic flexure. . 



Birmingham described the body of the pancreas as projecting forward as a promi- 

 nent ridge into the abdominal cavity and forming part of a shelf on which the 

 stomach lies. "The portion of the pancreas to the left of the middle line has a 

 very considerable antero-posterior thickness; as a result the anterior surface is of 

 considerable extent; it looks strongly upward, and forms a large and important 

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